瘰 之病，属三焦肝胆等经风热血燥，或肝肾二经精血亏损，虚火内动；人或恚怒忧思
，气逆于肝胆二经，二经多气少血，故怒伤肝，则木火动而血燥，肾阴虚则水不生木而血燥
，血燥则筋病，肝主筋也，故累累然结若贯珠。其候多生于耳前后，连及颈项，下至缺盆及
胸胁之侧。其初起如豆粒，渐如梅李核，或一粒，或三五粒，按之则动而微痛，不甚热，久
之则日以益甚，或颈项强痛，或午后微热，或夜间口干，饮食少思，四肢倦怠，或坚而不溃
，或溃而不合。皆由气血不足，故往往变为痨瘵。《外台秘要》云∶肝肾虚热则生 。《病
机》云∶瘰 不系膏粱丹毒火热之变，总由虚劳气郁所致。止宜以益气养营之药，调而治之
，其疮自消，盖不待汗之下之而已也。若不详脉证虚实之异，而概用追蚀攻下，及行气散血
之药，则必犯经禁病禁，以致血气愈损，必反为败证矣。治法∶若寒热 痛者，此肝火风热
，而气病也，用小柴胡汤以清肝火，兼服加味四物汤以养肝血；若寒热既止，而核不消散者
，此肝经火燥而血病也，用加味逍遥散以清肝火，六味地黄丸以生肾水；若肿高而稍软，面
色萎黄，皮肤壮热，脓已成也，宜针以决之，及服托里之剂；若经久不愈，或愈而复发，脓
水淋漓，肌肉羸瘦者，必纯补之剂，庶可收敛，若益气养营汤以补气血，六味丸以滋肾水、
培肝木，补中益气汤以健脾土是也。又如夏枯草能散结气，而有补养血脉之功，能退寒热，
虚者尽可用之。他若贝母、陈皮、木香、香附、青皮、地骨皮、山栀等，为化痰、散滞、
利膈之品，亦可随手加入。外又有隔蒜灸之法，或又用豆豉饼灸之，以琥珀膏贴之亦佳。
若其气血未损，而核不消者，方可服散坚之剂，如必效散，或遇仙无比丸，俟其毒一下即止
，更以益气养荣汤调理之。又有方用夏枯草、忍冬花、蒲公英各四、五钱同煎汤，朝夕代茶
饮之，十余日渐消；然此药但可治标，若欲除根，必须灸肩 、曲池二穴，以疏通经络
。如取此穴，当以指甲掐两肘尖、两肩尖骨缝间接处，其患处觉有酸麻者，方是其穴。此证
男子不宜太阳青筋，潮热咳嗽自汗；女人忌眼内红丝，经闭骨蒸烦热，必变成痨瘵而不可救
。又幼孩生此证者，系先天禀薄，后天生气不足，营卫并弱之故，宜用丸药以固先天肝肾，
煎剂以扶后天脾胃，方可消散而愈。
瘿瘤者，非阴阳正气所结肿，乃五脏瘀血浊气痰滞而成也。瘿者，阳也，色红而高突，
或蒂小而下垂；瘤者，阴也，色白而漫肿，无痒无痛，人所不觉。《内经》云∶肝主筋而藏
血，心裹血而主脉，脾统血而主肉，肺司腠理而主气，肾统骨而主水。若怒动肝火，血涸而
筋挛者，自筋肿起，按之如筋，久而或有赤缕，名曰筋瘤。若劳役火动，阴血沸腾，外邪所
搏而为肿者，自肌肉肿起，久而有赤缕，或皮俱赤者，名曰血瘤。若郁结伤脾，肌肉消薄，
外邪所搏而为肿者，自肌肉肿起，按之石软，名曰肉瘤。若劳伤肺气，腠理不密，外邪所搏
而壅肿者，自皮肤肿起，按之浮软，名曰气瘤。若劳伤肾水，不能荣骨而为肿者，自骨肿起
，按之坚硬，名曰骨瘤。当各求其所伤而治其本。大凡属肝胆二经结核，宜八珍加山栀、胆
草，以养气血、清肝火，六味丸以养肺金、生肾水。若属肝火血燥，须生血凉血，用四物、
二地、丹皮、酒炒黑胆草、山栀。若中气虚者，补中益气汤兼服之。倘治失其法，脾胃亏损
，营气虚弱，不能濡于患处，或寒气凝于疮口，营气不能滋养于患处，以致久不生肌而成漏
者，悉宜调补脾气，则气血壮而肌肉自生。若不慎饮食起居，及七情六淫，或用寒凉蚀药，
蛛丝缠、芫花线等法以治其外，则误矣。又瘿瘤诸证，只宜服药消磨，切不可轻用刀针掘破
，血出不止，多致危殆。
瘰疬这种病，属于三焦、肝胆等经络感受风热之邪导致血燥，或者是肝肾两经精血亏损，虚火在内扰动；或者人因愤怒、忧愁思虑，导致气机逆乱于肝胆二经，这两条经络多气少血，所以发怒伤肝，则木火妄动而血液干燥，肾阴不足则不能滋养肝木而导致血液干燥，血液干燥则筋脉患病，因为肝主司筋脉，所以淋巴结结块累累，像串起来的珠子一样。其症状多发生在耳前耳后，牵连到颈项，向下延伸至缺盆及胸胁侧面。初起时像豆粒大小，逐渐变成梅子或李子核的大小，可能是一颗，也可能是三五颗，按压时会移动且微痛，发热不明显，时间久了日益加重，可能出现颈项强直疼痛，或者午后轻微发热，或者夜间口干，食欲减退，四肢倦怠无力，或者肿块坚硬不溃破，或者溃破后伤口难以愈合。这都是由于气血不足，所以往往转变为痨瘵（慢性消耗性疾病）。《外台秘要》说：肝肾虚热就会生瘰疬。《病机》说：瘰疬不是由膏粱厚味、丹毒、火热之邪变化而成的，总归是由虚劳和气郁所致。只适宜用益气养营的药物，调理治疗它，疮疡自然消除，大概不需要通过发汗或攻下的方法。如果不详细辨别脉象和证候的虚实差异，而一概使用追蚀攻下，以及行气散血的药物，那么必定触犯经络禁忌和疾病禁忌，导致气血更加受损，必然反成败证。治疗方法：如果有寒热疼痛的症状，这是肝火和风热，属于气分病变，用小柴胡汤来清肝火，兼服加味四物汤来养肝血；如果寒热已经停止，但肿块不消散，这是肝经火燥导致血分病变，用加味逍遥散来清肝火，六味地黄丸来滋补肾水；如果肿块高突且稍软，面色萎黄，皮肤壮热，脓液已经形成，适宜针刺排脓，并服用托里透脓的药物；如果经久不愈，或者痊愈后复发，脓水淋漓，肌肉消瘦，必须用纯补的药物，才可能收敛，比如用益气养营汤来补气血，六味地黄丸来滋肾水、培补肝木，补中益气汤来健脾土。又如夏枯草能散结气，且有补养血脉的功效，能退寒热，体虚者完全可以应用。其他如贝母、陈皮、木香、香附、青皮、地骨皮、山栀等，是化痰、散滞、利膈的药物，也可以随手加入。外部还有隔蒜灸的方法，或者又用豆豉饼灸，贴上琥珀膏也很好。如果其气血未受损，但肿块不消散，才可以服用散坚的药物，如必效散，或者遇仙无比丸，等到毒邪排出后立即停止，再用益气养荣汤调理。又有方子用夏枯草、忍冬花、蒲公英各四、五钱同煎汤，早晚代茶饮用，十余天逐渐消退；然而这些药只能治标，若想除根，必须灸肩井穴、曲池穴两个穴位，以疏通经络。如果要取这两个穴位，应当用指甲掐按两肘尖、两肩尖骨缝间接处，患处感觉有酸麻感的，才是正确的穴位。此证男子不宜出现太阳青筋暴露，潮热咳嗽自汗；女子忌见眼内红丝，经闭骨蒸烦热，否则必然变成痨瘵而无法救治。又有幼童患此证的，是由于先天禀赋薄弱，后天生气不足，营卫都虚弱的缘故，适宜用丸药来固护先天肝肾，煎剂来扶持后天脾胃，才可以消散而痊愈。
瘿瘤，不是由阴阳正气凝结而成的肿物，而是五脏瘀血、浊气、痰滞积聚而成的。瘿，属阳，颜色红且高突，或者蒂小而下垂；瘤，属阴，颜色白且漫肿，没有痒痛，人们不易察觉。《内经》说：肝主筋而藏血，心包裹血而主脉，脾统血而主肉，肺司腠理而主气，肾统骨而主水。如果愤怒触动肝火，血液枯竭而筋脉挛急的，从筋脉肿胀而起，按压像筋一样，久了或有赤色血丝，名叫筋瘤。如果劳役过度火动，阴血沸腾，外邪搏结而成为肿物的，从肌肉肿胀而起，久了有赤色血丝，或者皮肤全红的，名叫血瘤。如果郁结损伤脾脏，肌肉消薄，外邪搏结而成为肿物的，从肌肉肿胀而起，按压石硬，名叫肉瘤。如果劳伤肺气，腠理不致密，外邪搏结而壅肿的，从皮肤肿胀而起，按压浮软，名叫气瘤。如果劳伤肾水，不能滋养骨骼而成为肿物的，从骨骼肿胀而起，按压坚硬，名叫骨瘤。应当分别寻找所受伤的部位而治其根本。大凡属于肝胆二经结核的，适宜用八珍汤加山栀、胆草，来养气血、清肝火，六味地黄丸来养肺金、生肾水。如果属于肝火血燥，须要生血凉血，用四物汤、二地（生地、熟地）、丹皮、酒炒黑胆草、山栀。如果中气虚的，补中益气汤兼服。倘若治疗失去法度，脾胃亏损，营气虚弱，不能濡润患处，或者寒气凝滞于疮口，营气不能滋养患处，以致长久不生肌而成漏症的，都适宜调补脾气，那么气血强壮而肌肉自然生长。如果不谨慎饮食起居，以及七情六淫的影响，或者使用寒凉腐蚀药物，蛛丝缠、芫花线等方法来治疗外部，那就错了。另外瘿瘤诸证，只适宜服药消磨，切不可轻易用刀针掘破，血流不止，多导致危殆。
Lymphadenopathy (Luoli) is a disease belonging to the Sanjiao, Liver, and Gallbladder meridians, caused by wind-heat pathogenic factors leading to blood dryness, or by deficiency of essence and blood in the Liver and Kidney meridians causing internal stirring of deficient fire; alternatively, it may result from anger, sorrow, or overthinking, causing Qi rebellion in the Liver and Gallbladder meridians. These two meridians are rich in Qi but poor in Blood; thus, anger injures the Liver, causing Wood-Fire to flare up and blood to dry out, while Kidney Yin deficiency fails to nourish Liver Wood, also resulting in blood dryness. Blood dryness leads to disorders of the sinews, as the Liver governs the sinews; consequently, nodules accumulate like beads on a string. Symptoms often appear around the ears, extending to the neck and nape, down to the Clavicular Fossa (Quepen) and the lateral aspect of the chest and hypochondrium. Initially resembling bean grains, they gradually enlarge to the size of plum or apricot pits, occurring singly or in groups of three to five. They are movable upon palpation with slight pain, without significant heat. Over time, they worsen daily, potentially accompanied by stiffness and pain in the neck, low-grade fever in the afternoon, dry mouth at night, poor appetite, and limb fatigue. The masses may remain hard without ulceration, or ulcerate without healing. All these stem from insufficiency of Qi and Blood, often transforming into Tuberculosis (Laozai). *Waitai Miyao* states: "Deficient heat in the Liver and Kidney generates lymphadenopathy." *Bingji* states: "Lymphadenopathy is not a transformation caused by rich food, Dan Du, or excessive heat, but is entirely due to consumptive disease and Qi stagnation." Treatment should solely employ herbs that tonify Qi and nourish the Ying (Nutritive) level to regulate and treat the condition, allowing the sores to resolve spontaneously, without resorting to diaphoresis or purgation. If one fails to distinguish the excess or deficiency patterns via pulse and symptoms, and indiscriminately uses caustic agents, purgatives, or herbs that move Qi and dissipate blood stasis, one will violate meridian and disease contraindications, further damaging Qi and Blood, inevitably leading to a critical state.
Treatment methods: If accompanied by chills, fever, and pain, this indicates Liver Fire and Wind-Heat affecting the Qi level; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) to clear Liver Fire, combined with Jia Wei Si Wu Tang (Modified Four Substance Decoction) to nourish Liver Blood. If chills and fever cease but nodules persist, this indicates Liver Meridian Fire-Dryness affecting the Blood level; use Jia Wei Xiao Yao San (Modified Free Wanderer Powder) to clear Liver Fire, and Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to generate Kidney Water. If the swelling is high and slightly soft, with sallow complexion and intense skin heat, indicating pus formation, puncture should be performed to drain it, along with administering formulas that support the interior (Tuo Li). If chronic, recurring, with dripping pus and emaciation, pure tonifying agents are necessary for resolution, such as Yi Qi Yang Ying Tang (Qi-Tonifying and Ying-Nourishing Decoction) to tonify Qi and Blood, Liu Wei Di Huang Wan to nourish Kidney Water and cultivate Liver Wood, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to strengthen Spleen Earth. Additionally, Xia Ku Cao (Prunella Vulgaris) can dissipate Qi stagnation and has the merit of nourishing blood vessels and relieving chills and fever; it is suitable for deficient patients. Others like Bei Mu (Fritillaria Bulb), Chen Pi (Citrus Peel), Mu Xiang (Aucklandia Root), Xiang Fu (Cyperus Rhizome), Qing Pi (Green Citrus Peel), Di Gu Pi (Lycium Bark), and Shan Zhi (Gardenia Fruit) are phlegm-resolving, stagnation-dispersing, and diaphragm-clearing agents that can be added as needed. Externally, garlic-partitioned moxibustion or fermented soybean cake moxibustion can be used, followed by application of Hu Po Gao (Amber Plaster). Only if Qi and Blood are intact yet nodules persist should hardness-dissipating agents like Bi Xiao San (Sure Effect Powder) or Yu Xian Wu Bi Wan (Immortal Peerless Pill) be taken; stop immediately after toxin expulsion, then regulate with Yi Qi Yang Rong Tang (Qi-Tonifying and Blood-Nourishing Decoction). Another prescription uses Xia Ku Cao, Jin Yin Hua (Honeysuckle Flower), and Pu Gong Ying (Dandelion), each 4–5 qian, decocted and drunk as tea morning and evening; nodules gradually subside in ten days. However, these herbs only treat symptoms; to eradicate the root, moxibustion on Jian Jing (GB21) and Qu Chi (LI11) is required to unblock meridians. To locate these points, press the interstices between the elbow and shoulder tips with fingernails; the correct point is where soreness and numbness are felt. For men, this condition is unfavorable if accompanied by distended blue veins on the head, tidal fever, cough, and spontaneous sweating; for women, it is contraindicated if accompanied by red filaments in the eyes, amenorrhea, bone-steaming fever, and irritability, as these indicate transformation into incurable tuberculosis. In children, this condition arises from weak congenital endowment and insufficient postnatal vital Qi, leading to weakness of both Ying and Wei levels. Pills should be used to consolidate congenital Liver and Kidney, while decoctions should support postnatal Spleen and Stomach, allowing resolution and recovery.
Goiter and Tumors (Ying Liu) are not swellings formed by the condensation of normal Yin and Yang Qi, but rather result from the accumulation of blood stasis, turbid Qi, and phlegm stagnation in the Five Zang organs. "Ying" belongs to Yang: it is red, elevated, and may hang down with a narrow base. "Liu" belongs to Yin: it is white, diffusely swollen, without itching or pain, often unnoticed. *Neijing* states: The Liver governs sinews and stores Blood; the Heart envelops Blood and governs vessels; the Spleen controls Blood and governs flesh; the Lung regulates interstices and governs Qi; the Kidney governs bones and controls water. If anger stirs Liver Fire, depleting Blood and causing sinew spasm, swelling arises from the sinews, feeling sinew-like upon pressure; with time, red threads may appear, named Sinew Tumor (Jin Liu). If labor-induced fire flares, boiling Yin Blood, and external pathogens collide causing swelling, it arises from muscle tissue, developing red threads or reddish skin over time, named Blood Tumor (Xue Liu). If emotional stagnation injures the Spleen, thinning muscles, and external pathogens collide causing swelling, it arises from muscle tissue, feeling stone-hard upon pressure, named Flesh Tumor (Rou Liu). If labor injures Lung Qi, making interstices loose, and external pathogens collide causing congestion and swelling, it arises from the skin, feeling floating and soft upon pressure, named Qi Tumor (Qi Liu). If labor injures Kidney Water, failing to nourish bones and causing swelling, it arises from the bone, feeling hard upon pressure, named Bone Tumor (Gu Liu). One must identify the injured organ to treat the root. Generally, for nodules in the Liver and Gallbladder meridians, use Ba Zhen Tang (Eight Treasure Decoction) plus Shan Zhi and Dan Cao to nourish Qi and Blood and clear Liver Fire, and Liu Wei Di Huang Wan to nourish Lung Metal and generate Kidney Water. For Liver Fire and blood dryness, employ blood-generating and blood-cooling herbs such as Si Wu Tang, Er Di (Shu Di Huang and Sheng Di Huang), Mu Dan Pi, wine-fried Hei Dan Cao, and Shan Zhi. For Middle Qi deficiency, combine with Bu Zhong Yi Qi Tang. If treatment is improper, leading to Spleen-Stomach damage and weak Ying Qi unable to moisten the affected area, or cold Qi congealing at the wound preventing nourishment, resulting in chronic non-healing fistulas, all cases require regulating and tonifying Spleen Qi, so that strong Qi and Blood naturally regenerate muscle tissue. Neglecting diet, lifestyle, Seven Emotions, and Six Excesses, or using cold/caustic medicines, spider silk binding, or Kansui thread therapies externally, constitutes error. Furthermore, for goiter and tumor conditions, only medication for gradual dissolution is appropriate; one must never lightly use knives or needles to pierce them, as uncontrollable bleeding often leads to critical danger.